NR-447 Collaborative Leadership in
Healthcare
2025/2026
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, Chamberlain College of Nursing
formal structure
highly planned, visible,
provides framework for
defining managerial
authority, responsibility
and accountability. Roles
and functions are defined
systematically arranged,
different people have
differing roles and rank
and hierarchy are evident.
Informal structure
unplanned, often hidden,
generally naturally forming
social network of
employees, typically
based on camaraderie,
resulting in more
immediate response from
individuals, which saves
peoples time and effort.
Chain of command
formal paths of
communication and
authority; those with the
greatest decision making
authority are at the top,
those with the least are at
the bottom; level of
position signifies status
and power.
, Span of control
Chamberlain College of Nursing
number of people directly
reporting to any one
manager represents that
managers span of control
and determines the
number of interactions
expected of him or her.
Inverse relation between
the span of control and
the number of levels in
hierarchy in an
organization.
Top level, middle level, levels of managers
and first line
examples of top level managers
chief nursing officer, chief
executive officer, chief
financial officer
unit supervisor, dept. examples of middle level managers
head, director
charge nurse, team examples of first level managers
leader, primary nurse.
scope responsibility of top level managers
look at organization as a
WHOLE as well as
external influences.
Scope responsibility of middle level managers
focus is on integrating unit
level day to day needs
with organizational needs.
focus primarily on day to scope responsibility of first level managers
day needs at unit levels.